Claims Specialist Jobs in Yorklyn, DE

Drive Clinical Excellence by reviewing coverage determinations and conducting Medication Therapy Management (MTM) for Medicare Advantage members, ensuring compliance with CMS regulations and enhancing...

Shape the future of clinical trials by ensuring adherence to protocols and regulations. Collaborate with site staff and investigators while safeguarding participant safety and data integrity. Elevate...

Empower clients by facilitating strategic benefits programs, enhancing relationships with carriers, and providing expert analysis, while managing complex accounts and guiding junior team members in a...

Lead the charge in operational oversight of HIMS coding data quality, guiding coder education activities to ensure compliance, accuracy, and continuous improvement in data management across acute care...

Drive enterprise-wide reporting solutions by independently designing, developing, and optimizing Microsoft Fabric-Power BI dashboards. Collaborate with teams to translate complex requirements into hig...

Optimize compliance programs across North America, ensuring regulatory adherence in financial services and debt collections, while driving performance improvements and fostering an ethical culture acr...

Optimize execution of Delivery Assurance activities in AMER, ensuring quality standards and engagement success. Collaborate with leaders to analyze performance, enhance partner capabilities, and deliv...

Unlock potential by leading strategic evidence generation and synthesis to inform market access and reimbursement strategies. Oversee cross-functional initiatives and translate complex data into actio...

Oversee clinical trial operations ensuring quality outcomes through effective management and team development while coordinating trials, optimizing performance, and maintaining productive stakeholder...

Drive optimal member care by leveraging clinical expertise and collaboration. Analyze utilization trends while advising leadership to ensure compliance with Medicare and state regulations, leading eff...

Innovate product strategies and lead cross-functional teams to deliver impactful solutions across multiple business domains. Drive key initiatives from ideation to launch, ensuring alignment with cust...

Transform product strategy by leading cross-functional teams to drive multi-vertical platform initiatives, ensuring alignment with business goals and enhancing customer experiences for impactful and s...

Transform product vision into strategy by leading cross-functional teams, driving platform success across multiple business lines. Influence stakeholders, deliver impactful solutions, and ensure align...

Transform physical therapy services through expert utilization review, ensuring quality care and adherence to guidelines while collaborating with providers to optimize outcomes and enhance patient rec...

Manage the quoting and pricing strategy to drive competitiveness and profitability. Lead cross-functional teams, ensuring operational excellence and compliance. Develop talent while establishing gover...

Execute complex financial reporting tasks, ensuring compliance with SEC regulations while leading internal and external audit processes to uphold the integrity and accuracy of financial statements acr...

Drive clinical optimization strategies across diverse practices, enhancing efficiency and satisfaction. Collaborate cross-functionally to develop actionable insights and reporting tools that support m...

Elevate quality assurance standards by leading a dedicated team that ensures compliance in clinical trials, driving innovative healthcare solutions. Collaborate across functions to implement best prac...

Explore opportunities to enhance market presence in Commercial Roof Coatings by generating leads, managing contractor relationships, and influencing decision-makers. Drive sales growth through strateg...

Optimize customer satisfaction by providing expert support and education in Nuclear Medicine and PET. Act as the primary contact for troubleshooting and training, collaborating with field teams to ens...

Make your mark at a pivotal role managing customer retention and growth, driving upsell strategies, analyzing territory data, and collaborating cross-functionally to enhance the customer experience in...

Lead successful implementations by analyzing business requirements, configuring software, and collaborating with teams to deliver solutions. Utilize critical thinking and communication skills to tackl...

Support hospitals and health systems in reimbursement processes, improving access to care through education on coding, billing, and compliance. Foster collaboration with stakeholders to identify barri...

Elevate your career by leading high-value, complex grantmaking initiatives. You will act as a key resource for donor compliance, oversee grant lifecycle management, and drive strategic improvements in...

Deliver impactful leadership and operational excellence in the EMS industry by managing day-to-day functions, driving business growth, and ensuring compliance while overseeing a dedicated team of EMTs...